NPI | 1316199821 |
---|---|
Former Name | ANDREA DECOSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 7839) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 800) |
Enumeration Date | 2008-10-15 |
Last Update Date | 2023-12-25 |